Beth Izreal Medical Center

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

2511501 Issued in NY

Legal business name

BETH IZREAL MEDICAL CENTER

Practice address

132 W 125TH St
6TH Floor
New York, NY 10027-4439

Phone

(212) 864-0904

Fax

(212) 865-6128

NPI assigned

Feb 10, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randy Sewald, M.D.

Title

Medical Director

Phone

(212) 256-2573

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1740586643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 W 125TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274439",
            "telephone_number": "212-864-0904",
            "fax_number": "212-865-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W 125TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274439",
            "telephone_number": "212-864-0904",
            "fax_number": "212-865-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH IZREAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "SEWALD",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-256-2573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NY",
            "license": "2511501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Israel Medical Center - Professional Services
• Beth Israel Medical Center Faculty Practice
• Beth Israel Medical Center Psychiatry & Behavioral Science
• Beth Isreal Medical Center
• Beth Isreal Medical Center Ny
• Raviteja Bethamcharla, MD
• Casidhe-Nicole Ramirez Bethancourt, MD
• Bethany Medical Clinic
• Bethany Medical Clinic of New York, PLLC
• Ashley Jayda Bethea, LMHC

• All providers in New York, NY
• Methadone Clinic in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.